Individual provider Active NPI

George Sam Wang, MD

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Aurora, CO
National Provider Identifier
1871649459
Registry record updated Dec 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
DR.0046566 Issued in CO
Practice address
13123 E 16TH Ave
B251
Aurora, CO 80045-7106
Phone
(720) 777-6888
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 46566 CO
Medical Toxicology (Emergency Medicine) Physician 207PT0002X 46566 CO
Pediatrics Physician 208000000X 46566 CO
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X DR.0046566 CO Primary

Addresses

Primary practice location

13123 E 16TH Ave
B251
Aurora, CO 80045-7106

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other identifiers 1

IdentifierTypeStateIssuer
67306357MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110121000871 CO Practitioner - Emergency MedicinePractitioner - Pediatric MedicinePractitioner - Medical Toxicology 3173702230 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
46566COMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians, Incorporated CurrentSince Oct 1, 2010 Accepting new patients
University Physicians Incorporated Pediatrics CurrentSince Oct 1, 2010 Accepting new patients
Denver Health and Hospital Authority CurrentSince Jul 22, 2013 Accepting new patients
Children'S Hospital Colorado Current Accepting new patients
Denver Health and Hospital Authority CurrentSince Jul 22, 2013 Accepting new patients

Locations

13123 E 16th Ave
Ste B130
Aurora, CO 80045

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

13123 E 16th Ave
#B251
Aurora, CO 80045
Phone (303) 724-2595

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

4090 Briargate Pkwy
Colorado Springs, CO 80920
Phone (719) 305-1234

777 Bannock St
Denver, CO 80204

Dept 1061
Denver, CO 80256

2525 S Downing St
Denver, CO 80210
Phone (303) 744-2706

Interoperability endpoints

  • Direct secure messaging: gwang12258@direct.dhha.org
  • Direct secure messaging: swang3940@direct.childrenscolorado.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1871649459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13123 E 16TH AVE",
            "address_2": "B251",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457106",
            "telephone_number": "720-777-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "GEORGE",
        "middle_name": "SAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "CO",
            "license": "46566",
            "primary": false
        },
        {
            "code": "207PT0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Medical Toxicology",
            "state": "CO",
            "license": "46566",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "46566",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "CO",
            "license": "DR.0046566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "67306357",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.